Update on Restless Legs Syndrome Management during Pregnancy

Restless legs syndrome (RLS) affects about 1 in 4 pregnant women, typically emerging in the second or third trimester and resolving after delivery. Iron deficiency, family history, and multiparity are consistent risk factors, with transient RLS conferring increased long-term risk of chronic disease. Management prioritizes nonpharmacologic measures and iron repletion, reserving medication for severe, refractory cases. Oral or intravenous iron remains the safest and most effective therapy, while dopamine agonists, gabapentinoids, opioids, and benzodiazepines are last-line options. Collaborative care ensures maternal comfort while minimizing fetal exposure.